KR102678238B1 - Medical devices for tissue hemostasis or suturing - Google Patents

Abstract

A medical device for tissue hemostasis or suturing used through an endoscope, comprising: a handle (1); a sheath device (2) attached to the handle (1); a clamp device (3) comprising a clamp base (6) and at least two clamp arms (7a, 7b), the clamp base (6) being particularly sleeve-shaped and installed at the distal end of the sheath device (2); a control line (4) extending through the sheath device (2) and moving reversibly in the distal and proximal directions; and an actuator (5) coupled to the proximal end of the control line (4) and operated to reversibly move the control line (4) in the distal and proximal directions.

Description

Medical devices for tissue hemostasis or suturing

This application claims priority of the European patent application entitled “Medical device for vascular hemostasis” and application number EP19169940.4, filed with the European Patent Office on April 17, 2019, the entire contents of which are incorporated by reference. It is hereby incorporated by reference in its entirety.

The present disclosure relates to the field of medical devices, and specifically to medical devices for tissue hemostasis or suturing used through an endoscope.

In the prior art, for example EP1328199B1, a medical device is disclosed which is particularly used to treat gastrointestinal bleeding. Specifically, these devices are used to restrict or stop the flow of blood through the blood vessel by installing a clamp or clip to clamp the bleeding blood vessel and apply sufficient contractile force to the blood vessel.

The medical device known by EP1328199B1 includes a handle and a sheath attached to the handle. The control line extends through the sheath and can be actuated by an actuator, which is coupled to the proximal end of the control line, causing the control line to move reversibly in the distal and proximal directions. The medical device further includes a clamp device, the clamp device includes a clip having a sleeve and two clamp arms installed on the distal end of the sheath, and the clamp arm is attached to the distal end of the control line through a J-shaped hook. are coupled. The cooperation method of the clamp arm and sleeve is as follows. When the control line is pulled in the proximal direction, the clamp arm is coupled to the front edge of the sleeve and elastically deformed inward to close, and when the control line is pushed in the distal direction, the clamp arm is pushed out from the sleeve to the distal side, and the clamp arm It is automatically reopened by its elastic recovery force. Since the clamp device can be opened and closed repeatedly, the clamp device can be installed in an easy manner.

Once the clamp device is positioned correctly, the clamp device, including the clamp arm and sleeve, can be separated from the rest of the medical device. Accordingly, when the clamp device is completely closed, the control line is further pulled back to cause the J-shaped hook to break, thereby interrupting the connection between the clamp arm and the control line. In addition, the control line is further pulled back to drive the holding member connecting the control line and the sleeve to separate the holding member and the sleeve, thus separating the control line and the sleeve.

In order to solve at least one problem of the prior art, the present disclosure aims at providing a medical device of the type described above, which is easy to operate, easy to manufacture and assemble, for example. According to the present disclosure, at least one problem of the prior art can be solved through the following types of medical devices.

The present disclosure relates to a medical device for tissue hemostasis or suturing used through an endoscope, the medical device comprising:

handle;

a sheath device attached to the handle;

A clamp device comprising a clamp base and at least two clamp arms, and in particular, the clamp base has a sleeve shape and is installed at the distal end of the sheath device;

a control line extending through the sheath device and reversibly moving in the distal and proximal directions; and

an actuator coupled to the proximal end of the control line and operated to reversibly move the control line in a distal direction and a proximal direction;

Here, the clamp arm is coupled to the distal end of each control line, the clamp device is operated through movement of the control line to open and close the clamp arm, and the movement of the control line in the proximal direction is converted into a closing movement of the clamp arm. and the movement of the control line in the distal direction is converted into an opening movement of the clamp arm.

The clamp arm is coupled to the control line through a pivot pin, and the pivot pin is installed at the distal end of the control line and extends to penetrate a corresponding through hole provided at the tail end of the clamp arm, and is connected to the clamp arm at the proximal side of the through hole. An outlet passage is installed at the tail end, and after the clamp arm is closed, the control line is moved to the proximal side, and the pivot pin is released from the engagement with the through hole and the clamp arm through the outlet passage, and the clamp arms on both opposing sides of the outlet passage are released. Separate the control line and clamp arm by preventing the tail end from opening and breaking.

According to the present disclosure, since the clamp arm is directly coupled to the control line, there is no need to provide a separate connection element, for example in the form of a J-shaped hook. Specifically, the control line has a pivot pin installed at its distal end, and the pivot pin is coupled to a corresponding through hole installed at the proximal end of the clamp arm.

The through hole opens toward the proximal end of the clamp arm. Specifically, an outlet passage is provided, which is designed to be small enough to prevent the pivot pin from unintentionally leaving the clamp arm, but a sufficiently large traction force is applied to the control line to force the pivot pin out of the through hole as intended through the outlet passage. By pulling out, the tail ends of the clamp arms on both opposing sides of the outlet passage can be opened and deformed.

The outlet passage may be, for example, a slot at the tail end of the clamp arm.

According to another embodiment of the present disclosure, the tail end of the clamp arm is elastically deformed or plastically deformed when opened. Under any circumstances, this arrangement ensures that the tail end does not fracture, thus avoiding parts of the arm that are prone to fracture being randomly left in the patient's body.

According to another embodiment of the present disclosure, the tail ends of the clamp arms on opposite sides of the outlet passage are coupled to the rear surface of at least one shoulder portion of the clamp base to lock the clamp arm to the clamp base. Optionally, the tail ends of the clamp arms on both opposing sides of the outlet passage are coupled to the rear surface of at least one shoulder portion of the clamp base to form hooks that lock the clamp arms to the clamp base.

The shoulder portion may consist of an annular protrusion of the clamp base, wherein the annular protrusion forms a distal section with a central opening in the clamp base, and when the clamp arm is fully closed, the proximal end of the clamp arm passes through the central opening. It extends into the clamp base.

If the pivot pin is pulled out of engagement with the clamp arm, the clamp arm is plastically deformed at the tail ends on both opposing sides of the outlet passage, and in this case, it is arranged as follows. The proximal end of the clamp arm is located on the back of the clamp base shoulder, that is, located on the proximal side of the clamp base shoulder, so that the proximal end of the clamp arm is plastically deformed and coupled to the back of the shoulder, thereby locking the clamp arm to the clamp base. The arm cannot be disassembled from the clamp base again. As a result, there is no need for a separate, independent locking element.

According to another embodiment of the present disclosure, a coupling head is provided at the distal end of the control line, and a pivot pin is installed on the coupling head. The pivot pin may have two pivot pin portions, and the two pivot pin portions extend from opposite sides of the coupling head into through holes of the clamp arm located on opposite sides of the coupling head. This arrangement is useful when placing the clamp arms on different sides of the coupling head. Typically, the coupling head may include a U-shaped retaining structure open at its distal side, where a portion of the clamp arm is disposed between legs of the U-shaped retaining structure, and a pivot pin is positioned between the legs of the U-shaped retaining structure. It is held between the parts and extends to penetrate the through hole of the clamp arm, and in particular, the clamp arm extends laterally outward from the open side of the U-shaped holding structure. In this embodiment, the clamp arms are arranged in a U-shaped holding structure so that they can be in direct contact with each other.

According to another aspect of the present disclosure, the object is solved by such medical device as initially mentioned, wherein the clamp device includes exactly two clamp arms and guide pins, and the two clamp arms are independent It is installed as an element and is coupled to the distal end of the control line to pivot about a common pivot axis defined by a pivot pin. Each clamp arm is provided with a guide groove, and the guide grooves of the two clamp arms are partially aligned with each other. Overlapping, the guide pin is attached to the clamp base, extends to penetrate the overlapping portion of the guide groove, and the movement of the control line in the proximal direction is converted into a closing movement of the clamp arm through the combination of the guide pin and the guide groove. , characterized in that the movement of the control line in the distal direction is converted into an opening movement of the clamp arm centered on the pivot axis.

According to this embodiment, the clamp arms are independent elements/members that are not directly connected to each other. Conversely, the clamp arms are each coupled to the pivot pin through its through hole and coupled to the control line. Additionally, the clamp arm is coupled to the clamp base through a combination of a guide pin and a guide groove, so that the axial movement of the control line is converted into a closing/opening movement of the clamp arm centered on the pivot axis. According to another embodiment of the present disclosure, a guide pin is held between two bearing arms extending distally from the clamp base, and in particular at the free end of the bearing arms. The clamp base forms the bearing arm and clamp housing.

According to another embodiment of the present disclosure, a retaining convex portion is provided on the clamp arm, the retaining convex portion extends from the side of the guide groove into the guide groove, and the retaining convex portion allows a guide pin to pass through the retaining convex portion to reach the distal end of the guide groove. and is designed to prevent the guide pin from passing in the opposite direction. In particular, the guide groove includes a straight distal end extending in the axial direction, and the guide pin moves in the straight distal end but does not cause rotation of the clamp arm, The retaining convexity extends into the straight distal end. In particular, a concave portion is provided on the side of the guide groove at the distal side of the retaining convex portion, and the retaining convex portion is elastically deformed to enter the concave portion, allowing the guide pin to pass through the retaining convex portion and reach the distal end position of the guide groove.

According to this embodiment, the guide pin is secured to the distal end of the guide groove through the retaining convex portion, thereby locking the clamp to the clamp base. As a result, there is no need for a separate locking element.

In another embodiment of the present disclosure, the clamp base is reversibly and directly connected to the sheath device through at least one connection element, and a release device cooperating with each connection element is provided, the clamp arm being positioned in a proximal direction when the clamp arm is closed. Movement of a control line to can actuate the release device to cause the clamp base to be released from the sheath device, wherein each connection element is fixedly attached to the clamp base or is a part of the clamp base and is releasable to the sheath device. connected, or wherein each connecting element is fixedly attached to or part of a sheath device and releasably connected to the clamp base.

According to this embodiment, the clamp base and the sheath device are directly connected to each other via corresponding connecting elements, which are fixedly connected to one of the elements and releasably connected to the other element. Thereby, a very secure and stable connection is obtained between the clamp base and the sheath device, without the need for any independent connection elements. Accordingly, the medical device according to the present disclosure is simple to design and easy to manufacture. When the clamp arm is closed, actuate the connecting element to release the clamp base from the sheath device. Specifically, the arrangement allows the clamp base to be released from the sheath device when the clamp arm is closed and the control line is moved further in the proximal direction.

According to an embodiment of the present disclosure, the sheath device includes a sheath and a connector fixedly installed at the distal end of the sheath. For example, the connector can be welded to the sheath. Optionally, the sheath may be a stretchable helical sheath.

Alternatively, instead of a single connection element, a plurality of connection elements tilted at regular angles can be installed along the outer circumference of the clamp base. In particular, two connection elements can be installed on opposite sides of the clamp base.

According to another embodiment of the present disclosure, each connecting element is fixedly attached to the clamp base or is a part of the clamp base, is releasably connected to the sheath device (in particular, the connector of the sheath device), and has a free coupling member formed by the coupling portion. It has a stage, and the engaging portion is engaged with a corresponding engaging means of the sheath device (in particular, a recess, preferably an annular groove, provided on the outer peripheral surface of the sheath device) to releasably connect the clamp base to the sheath device. If the recess is formed as an annular groove, the clamp base can rotate 360° relative to the sheath device.

Another embodiment of the present disclosure provides a release device including a protrusion, the protrusion is provided on a control line, and moves the control line proximally when the clamp arm is closed, so that the protrusion is coupled to each connection element to clamp The base is arranged to be released from the sheath device, wherein the corresponding projection is formed in particular as part of a coupling head provided at the distal end of the control line.

According to another embodiment of the present disclosure, the connecting elements are coupled to the protrusions and are elastically or plastically deformed, thereby disengaging the connecting portion of each connecting element from the corresponding connecting means of the sheath device. In this situation, optionally, each connecting element is installed in the form of a connecting arm having an inward protruding portion, and the protruding portion is coupled to the inward protruding portion, such that the connecting arm is elastically or plastically deformed outward.

In this embodiment, the protrusion provided on the control line is coupled to the inward portion so that the connecting arm is elastically deformed outward, and its free end coupled to the corresponding engaging means of the sheath device is also deformed outward and disengaged from the engaging means. do.

According to another embodiment of the present disclosure, each connecting element is coupled to the protrusion and plastically deformed, thereby disengaging the connecting portion from the corresponding connecting means of the sheath device. Optionally, each connection element is formed as a C-type connection element, wherein the central rod of the C-type connection element is attached to the clamp base at the connection site and the leg portion of the distal C-type connection element extends medially into the clamp base to form a protrusion. The leg portion of the other proximal C-shaped connecting element forms a coupling portion and extends inwardly to engage the corresponding engaging means of the sheath device, and also allows engagement of the protrusion and the leg portion of the distal C-shaped connecting element. Through this, the connection element is pivoted about the connection area to disengage with the leg portion and sheath device of the proximal C-type connection element.

Both of these two embodiments achieve a simple structure/design of the clamp base, thereby maintaining relatively low manufacturing costs.

When the connection elements are fixedly attached to or part of a sheath device (particularly a connector of the sheath device) and releasably connected to the clamp base, another embodiment of the present disclosure provides that each connection element has elasticity and can be elastically deformed. installed in the form of a connecting arm, wherein the proximal end of the connecting element is attached to the sheath device or is part of the sheath device, and the free distal end of the connecting element forms a connecting portion, which is attached to the corresponding connecting means of the clamp base (in particular the clamp is coupled to a recess (preferably an annular groove) provided on the outer peripheral surface of the base, and each connecting element is also provided with an inward protruding portion, and the release device includes a protrusion, in particular a cylindrical protrusion disposed on the control line, The protrusion cooperates with the inward protruding part, so that the protrusion presses the inward protruding part outward, causing the connecting element to be elastically deformed, so that when the protruding part is located between the inward protruding parts, the engaging part of the connecting element is pressed inward to achieve the corresponding engagement of the clamp base. It is coupled to the means, and when the control line is further moved in the proximal direction in the closed state of the clamp arm, the coupling of the protrusion and the inward protruding portion is released, so that the inward protruding portion is deformed inward due to its elastic recovery force and connected. Disengage the corresponding connecting means of the part and the clamp base.

In this embodiment, the elastic connecting arm forming the connecting element effectively maintains engagement with the recess/groove provided in the clamp base through engagement of the protruding portion with the inwardly protruding portion of the connecting arm. Once the protrusion is no longer positioned between the protruding parts due to the pullback of the control line directed in the proximal direction, the latter is elastically deformed inward by its restoring force when this bond no longer exists. In other words, the protrusion of the control line is ejected from the range of the protruding portion, thereby passively releasing the connection between the sheath device and the clamp base.

Optionally, on the distal side of the protruding portion, the connecting element extends outside the connector through a window provided in the circumferential wall of the connector, wherein when the protruding portion is located between the inward protruding portions, the connecting element is deformed outwardly. The connection element is pressed against the contact surface (in particular the inclined contact surface) on the proximal side of the window, such that the distal end of the connection element deforms inward so that its connection part is pressed against the corresponding engagement means of the clamp base.

Hereinafter, embodiments of the present disclosure will be described with reference to the accompanying drawings. In these accompanying drawings:
1 shows a front view of a medical device according to one embodiment of the present disclosure.
FIG. 2 shows the front distal end portion of the medical device of FIG. 1 in a local cross-sectional view and at an enlarged scale.
Figure 3 shows a diagram of a clamp arm connected through a pivot pin in a medical device in a fully open state.
Figure 4 shows a perspective view of the distal end portion of a medical device with a clamp device.
Figure 5 shows an enlarged perspective view of the clamp base of the clamp device.
Figure 6 shows another enlarged perspective view of the clamp base of the clamp device.
Figure 7 shows a sheath device with a spiral sheath and connector in a medical device.
Figure 8 corresponds to Figure 7 and shows the connector being mounted on the sheath.
Figure 9 is a perspective view showing the clamp base attached to the sheath device.
Figure 10 is a local cross-sectional view of the arrangement of Figure 9;
Figure 11 is a local cross-sectional view of the clamp device, where the clamp arm is in a fully open state.
Figure 12 is a local cross-sectional view of the clamp device, where the clamp arm is partially closed.
Figure 13 is a local cross-sectional view of the clamp device, where the clamp arm is closed.
Figure 14 corresponds to Figure 13 and is not excised.
Figure 15 corresponds to Figure 13 and shows an arrangement in which the control line is further retracted.
Figure 16 corresponds to Figure 15, where the clamp base is shown in cross-section and the clamp arm is in the fully closed and fixed position.
Figure 17 shows the engagement of the guide pin and the guide groove of the clamp arm at the position of Figure 16 at an enlarged scale.
Figures 18 to 20 correspond to Figures 15 and 16 and show the process of separating the control line and the clamp arm.
21-23 are local cross-sectional views of the clamp base and illustrate release of the clamp base from the sheath device.
Figure 24 is a perspective view showing the clamp device separated from the sheath device.
25 and 26 are top views of the clamp base before and after separation from the sheath device.
Figure 27 shows a front view of a medical device according to another embodiment of the present disclosure.
FIG. 28 shows the front distal end portion of the medical device of FIG. 27 in local cross-section and at an enlarged scale.
Figure 29 is a diagram showing a fully open state of a clamp arm connected through a pivot pin in a medical device.
Figure 30 shows an enlarged perspective view of the clamp base of the clamp device.
Figure 31 shows another enlarged perspective view of the clamp base of the clamp device.
Figure 32 shows a sheath device with a spiral sheath and connector in a medical device.
Figure 33 corresponds to Figure 32 and shows mounting the connector to the sheath.
Figure 34 is a perspective view showing the clamp base attached to the sheath device.
Figure 35 is a cross-sectional view of the arrangement of Figure 34.
Figure 36 is a local cross-sectional view of the clamp device, where the clamp arm is in a fully open state.
Figure 37 is a local cross-sectional view of the clamp device, where the clamp arm is partially closed.
Figure 38 is a local cross-sectional view of the clamp device, where the clamp arm is closed.
Figure 39 corresponds to Figure 38 and is not excised.
Figure 40 corresponds to Figure 38 and shows the arrangement from a different angle.
Figure 41 corresponds to Figure 40 and shows an arrangement in which the control line is further retracted.
Figure 42 corresponds to Figure 41, where the clamp base is shown in cross-section and the clamp arm is in the fully closed and locked position.
Figure 43 shows the arrangement of Figure 42 at a larger scale.
Figures 44 and 45 are local cross-sectional views showing the process of separating the control line and the clamp arm after fixing the clamp arm in a closed state.
Figures 46 and 47 correspond to Figures 41 and 42 and illustrate the process of closing the clamp arm, fixing it in a closed state, and simultaneously separating the control line and the clamp arm.
Figures 48-50 are local cross-sectional views of the clamp base and illustrate release of the clamp base from the sheath device.
Figure 51 is a perspective view showing the clamp device separated from the sheath device.
Figures 52 and 53 are top views of the clamp base before and after separation from the sheath device.
Figure 54 shows a front view of a medical device according to another embodiment of the present disclosure.
FIG. 55 shows the front distal end portion of the medical device of FIG. 54 in a local cross-sectional view at an enlarged scale.
Figure 56 is a diagram showing a fully open state of a clamp arm that is operably connected through a pivot pin in a medical device.
Figure 57 shows an enlarged perspective view of the clamp base of the clamp device.
Figure 58 shows another enlarged perspective view of the clamp base of the clamp device.
Figure 59 is a diagram showing the clamp base attached to the sheath device.
Figure 60 is a cross-sectional view of the arrangement of Figure 59;
Figure 61 is a local cross-sectional view of the clamp device, where the clamp arm is in a fully open state.
Figure 62 is a local cross-sectional view of the clamp device, where the clamp arm is partially closed.
Figure 63 is a local cross-sectional view of the clamp device, where the clamp arm is closed.
Figure 64 corresponds to Figure 63 and shows an arrangement in which the control line is further retracted.
Figure 65 corresponds to Figure 64, where the clamp base is shown in cross-section and the clamp arm is in the fully closed and secured position.
Figure 66 shows the engagement of the guide pin and the guide groove of the clamp arm at the position of Figure 65 at an enlarged scale.
Figures 67 to 69 correspond to Figure 64 and show the process of separating the control line and clamp arm.
70 and 71 are local cross-sectional views of the clamp base and illustrate release of the clamp base from the sheath device.
Figure 72 is a perspective view showing the clamp device separated from the sheath device.
Figure 73 is a top view of the clamp base before being separated from the sheath device.

1 to 26, one embodiment of a medical device according to the present disclosure is shown. The medical device is used to install a clamp used for hemostasis of blood vessels located within the stomach, where the clamp is transported to the target site through an endoscope.

The medical device includes a handle (1), a sheath device (2) attached to the handle (1) and a clamp device (3) installed at the distal end of the sheath device (2). The control line (4) extends through the sheath device (2), the proximal end of which is connected to an actuator (5), which is slidably held on the handle (1), and the control line (4) extends in a circular motion. It can be operated to move reversibly in the superior and proximal directions.

The clamp device 3 includes a clamp base 6 formed as a sleeve and two clamp arms 7a, 7b, each of which is coupled to the distal end of the control line 4. Specifically, the two clamp arms (7a, 7b) are independent elements/members coupled to the control line (4) through the pivot pin (8), and the pivot pin is installed at the distal end of the control line (4). , extends and passes through corresponding through holes 9 provided at the proximal ends of the clamp arms 7a, 7b. In this embodiment, the pivot pin (8) is installed in the coupling head (10), which is installed at the distal end of the control line (4).

The coupling head 10 has a U-shaped or branched retaining structure whose distal end is open, and clamp arms 7a, 7b are partially disposed between the legs of the U-shaped retaining structure. The pivot pin (8) is held between the legs of the U-shaped holding structure and extends to penetrate the through-holes (9) of the clamp arms (7a, 7b), and the clamp arm is also provided on the open side of the U-shaped holding structure. extends laterally outward.

The two clamp arms (7a, 7b) are coupled to the distal end of the control line (4), allowing the clamp arms to rotate around a common pivot axis formed by the pivot pin (8) to realize opening and closing of the clamp arms. . Each clamp arm (7a, 7b) is provided with a guide groove (11), and the guide grooves (11) of the clamp arms (7a, 7b) partially overlap each other. The clamp device 3 further includes a guide pin 12, which is attached to the clamp base 6 and extends to penetrate the overlapping portion of the guide groove 11, and the guide pin 12 and the guide Through the combination of the grooves 11, the movement of the control line 4 in the proximal direction is converted into a closing movement of the clamp arms 7a, 7b, and the movement of the control line 4 in the distal direction is converted into a pivot movement. This is converted into an opening movement of the clamp arms (7a, 7b) centered on the axis. In this embodiment, the guide pin 12 is maintained between two bearing arms 13a and 13b, and the two bearing arms extend vertically from the distal end of the clamp base 6 to form a branched structure, Clamp arms 7a, 7b are disposed between these bearing arms 13a, 13b and extend laterally outward from the structure. The clamp base 6 and bearing arms 13a and 13b together form a clamp housing.

In particular, as shown in FIG. 3, the through hole 9 for the pivot pin 8 at the proximal ends of the clamp arms 7a, 7b opens to the rear (proximal) side. In other words, an outlet passage 14 is provided at the tail end of the clamp arms 7a and 7b on the proximal side of the through hole 9, and after the clamp arms 7a and 7b are closed, the pivot pin 8 passes through the outlet passage. ) is pulled out from the through hole (9), and the tail ends (15, 16) of the clamp arms (7a, 7b) on both opposing sides of the opening are spread, but are not broken. As a result, the control line 4 and the clamp arms 7a and 7b are separated from the clamp device 3. Here, the outlet passage 14 consists of a slot at the tail end of the clamp arms 7a and 7b.

In the above embodiment, the tail ends 15, 16 of the clamp arms 7a, 7b are plastically deformed when opened and formed into hooks, and the hooks are coupled to the back of the shoulder portion 17 of the clamp base 6. This locks the clamp arms 7a and 7b to the clamp base, and this will be described in detail below. The shoulder portion 17 is made of an inward annular protrusion, which is installed at the distal end of the clamp base 6 and forms its distal end surface.

The sheath device (2) includes a helical sheath (2a) and a connector (2b) connected to the handle (1), the connector being installed at the distal end of the helical sheath (2a) and laser welded to the sheath, The sheath device 2 is formed as an inseparable unit. The sheath device 2 is connected to the clamp base 6 through two connection elements 18 in the form of elastic connecting arms, and the two connection elements are formed on opposite sides of the clamp base, and the clamp base 6 and forms an integrated structure. Specifically, the distal end of the connecting element 18 is fixedly connected to the clamp base 6, and the free proximal end of the connecting element 18 forms a coupling portion, which is connected to the circumferential surface of the connecting tube 2b. It is coupled to corresponding coupling means provided in to couple the clamp base (6) to the sheath device (2). Here, the coupling portion of the connecting element 18 is formed as an inward coupling portion, and the coupling portion is coupled to the annular groove 19, which is a coupling means installed on the outer surface of the connecting pipe 2b, and the clamp base 6. to be coupled to the sheath device (2).

As can be seen in Figure 2, the distal end of the connector 2b extends into the sleeve-shaped clamp base 6, such that the annular groove 19 is located within the clamp base 6.

The connection element 18 has an inwardly protruding portion 18a in its middle portion. This inwardly protruding portion 18a cooperates with a protrusion 20 of the control line 4, which protrusion forms part of a release device and is actuated through movement of the control line 4 in the proximal direction, When the clamp arms (7a, 7b) are closed, the clamp base (6) is released from the sheath device (2). In detail, the protrusion 20 consists of the rear proximal part of the coupling head 10 of the control line 4 and is installed to be coupled to the inwardly protruding part 18a of the connection element 18, When the control line 4 is pulled in this direction, the protruding portion 18a of the connecting element 18 is coupled to the protruding portion 20 and is plastically deformed outward, so that the free end of the connecting element 18 is connected to the connecting pipe 2b. Allow it to deviate from the annular groove (19).

In use, the clamp device 3 is transported to the target site through an endoscope, and the clamp device 3 is fixed at a predetermined position on the target site with respect to the blood vessel. In order to clamp the blood vessel, the clamp arms 7a, 7b can be repeatedly opened and closed by causing the control line 4 to move in the distal direction and the proximal direction through the actuator 5.

Once the clamp device (3) is installed, the clamp arms (7a, 7b) and control line (4) are separated. For this purpose, the control line 4 is pulled in the proximal direction to completely close the clamp arms 7a, 7b and secure them in the closed position, as shown in FIGS. 17 to 19. These accompanying drawings show that the guide groove 11 has a straight distal end 11a extending in the axial direction, and the guide pin 12 is movable at the distal end but is separate from the clamp arms 7a and 7b. does not cause rotation of When the guide pin 12 reaches the distal end position of the guide groove 11, the guide pin is fixed/locked at this position through the retaining convex portions 21 of the clamp arms 7a and 7b. The retaining convex portion 21 extends into the straight end 11a of the guide groove 11 from the side of the guide groove, and the retaining convex portion allows the guide pin 12 to pass through the retaining convex portion to the distal end of the guide groove 11. It is designed to reach and prevent the guide pin 12 from passing along the opposite direction. Specifically, when the guide pin 12 is pressed against the proximal side of the guide groove, the holding convex portion 21 is elastically deformed and enters the concave portion 11b on the side of the guide groove 11, The guide pin (12) passes through the retaining convex portion (21) to reach the distal end position of the guide groove (11), and when the guide pin (12) has already reached its final position, the retaining convex portion provides its elastic recovery force. It is restored to its initial shape and engages the back of the guide pin 12, but when the guide pin 12 is pressed against the distal end of the guide groove, the retaining convex portion is not deformed to open the guide groove 11, and the guide pin ( 12) is designed to be locked at the distal end position of the guide groove (11). As a result, the clamp arms 7a and 7b are firmly locked to the clamp base 6 and thus are firmly locked to the clamp housing.

If the control line (4) is further pulled back, the clamp arms (7a, 7b) can no longer proceed with the displacement movement, and in this situation, the pivot pin (8) is pulled through the outlet passage (14) at the rear of the clamp arm. Pull it out from the through hole (9). In the above process, the tail portions 15 and 16 located on opposite sides of the outlet passage 14 are plastically opened and coupled to the rear surface of the shoulder portion 17 of the clamp base 6, and the clamp arms 7a and 7b ) to the clamp base (6).

In order to separate/release the clamp base 6 from the sheath device 2, the control line 4 is further pulled back in the proximal direction so that the projection 20 of the coupling head 10 is connected to the connection element 18. is coupled to the inward protruding portion 18a (see FIG. 22), and pushes the protruding portion 18a outward to plastically deform, thereby forming the free end of the connecting element 18 and the annular groove 19 of the connecting pipe 2b. The coupling is released (FIGS. 23 and 24) so that the clamp device 3, which includes the clamp base 6 and the clamp arms 7a and 7b, can be pulled out to the sheath device 2.

27 to 53 show an example of a medical device according to another example of the present disclosure. The basic design according to the above embodiment corresponds to the previous embodiments. The difference between these embodiments lies only in the specific coupling method of the control line 4 and the clamp arms 7a and 7b and the design and function of the connection element 18.

The medical device according to the above embodiment includes a handle (1), a sheath device (2) attached to the handle (1), and a clamp device (3) installed at the distal end of the sheath device (2). The control line (4) extends through the sheath device (2), the proximal end of which is connected to an actuator (5), which is slidably held on the handle (1), and the control line (4) extends in a circular motion. It can be operated to move reversibly in the superior and proximal directions.

The clamp device 3 includes a clamp base 6 formed as a sleeve and two clamp arms 7a, 7b, each of which is coupled to the distal end of the control line 4. Specifically, the two clamp arms (7a, 7b) are independent elements/members coupled to the control line (4) through the pivot pin (8), and the pivot pin is installed at the distal end of the control line (4). , extends and passes through corresponding through holes 9 provided at the proximal ends of the clamp arms 7a, 7b. In this embodiment, the pivot pin (8) is installed in the coupling head (10), which is installed at the distal end of the control line (4). In the above embodiment, the coupling head 10 is flat and disposed between the clamp arms 7a and 7b, and the pivot pin 8 extends from opposite sides of the coupling head 10 to clamp the clamp arm 7a. , 7b) is provided with two pivot pin parts coupled to each through hole (9).

The two clamp arms (7a, 7b) are coupled to the distal end of the control line (4), allowing the clamp arms to rotate around a common pivot axis formed by the pivot pin (8) to realize opening and closing of the clamp arms. .

Each clamp arm (7a, 7b) is provided with a guide groove (11), and the guide grooves (11) of the clamp arms (7a, 7b) partially overlap each other. The clamp device 3 further includes a guide pin 12, which is attached to the clamp base 6 and extends to penetrate the overlapping portion of the guide groove 11, and the guide pin 12 and the guide Through the combination of the grooves 11, the movement of the control line 4 in the proximal direction is converted into a closing movement of the clamp arms 7a, 7b, and the movement of the control line 4 in the distal direction is converted into a pivot movement. This is converted into an opening movement of the clamp arms (7a, 7b) centered on the axis. In this embodiment, the guide pin 12 is maintained between two bearing arms 13a and 13b, and the two bearing arms extend vertically from the distal end of the clamp base 6 to form a branched structure, Clamp arms 7a, 7b are disposed between these bearing arms 13a, 13b and extend laterally outward from the structure. The clamp base 6 and bearing arms 13a and 13b together form a clamp housing.

At the proximal ends of the clamp arms 7a, 7b, a through hole 9 for the pivot pin 8 opens on the rear (proximal) side. In other words, an outlet passage 14 is provided at the tail end of the clamp arms 7a and 7b on the proximal side of the through hole 9, and after the clamp arms 7a and 7b are closed, the pivot pin 8 passes through the outlet passage. ) is pulled out from the through hole (9), and the tail ends (15, 16) of the clamp arms (7a, 7b) on both opposing sides of the opening are spread, but are not broken. As a result, the control line 4 and the clamp arms 7a and 7b are separated from the clamp device 3. Here, the outlet passage 14 consists of a slot at the tail end of the clamp arms 7a and 7b.

In the above embodiment, the tail ends 15 and 16 of the clamp arms 7a and 7b are elastically deformed when opened and are formed into hooks, and the hooks are coupled to the back of the shoulder portion 17 of the clamp base 6. locks the clamp arms (7a, 7b) to the clamp base. The shoulder portion 17 consists of an inward annular protrusion, which is installed at the distal end of the clamp base 6 and forms its distal cross-section (FIGS. 44 and 45).

The sheath device 2 includes a spiral sheath 2a and a connector 2b connected to the handle 1, and the connector is installed at the distal end of the spiral sheath 2a and is laser welded to the sheath to form the sheath. This allows the device 2 to be formed as an inseparable unit. The sheath device 2 is connected to the clamp base 6 through two connection elements 18 in the form of elastic connecting arms, and the two connection elements are formed on opposite sides of the clamp base, and the clamp base 6 and forms an integrated structure. Specifically, the distal end of the connecting element 18 is fixedly connected to the clamp base 6, and the free proximal end of the connecting element 18 forms a coupling portion, which is connected to the circumferential surface of the connecting tube 2b. It is coupled to corresponding coupling means provided in to couple the clamp base (6) to the sheath device (2). Here, the coupling portion of the connecting element 18 is formed as an inward coupling portion, and the coupling portion is coupled to the annular groove 19, which is a coupling means installed on the outer surface of the connecting pipe 2b, and the clamp base 6. to be coupled to the sheath device (2).

As can be seen in Figure 28, the distal end of the connector 2b extends into the sleeve-shaped clamp base 6 so that the annular groove 19 is located within the clamp base 6.

The connecting element 18 according to the above embodiment is formed as a C-shaped connecting arm, where the central rod of the C-shaped connecting arm is connected through two plastically deformable narrow webs 22 at the connecting portions on both opposing sides. Another proximal C-shaped connecting arm that is attached to the clamp base 6 and can be coupled to the protrusion 20 by extending the leg portion of the distal C-shaped connecting arm inwardly to the clamp base 6, forming a coupling portion. The leg portion extends inward and is coupled to the annular groove 19 of the connector 2b. Through this arrangement, when the control line 4 is pulled in the proximal direction from the closed position of the clamp arms 7a, 7b, the protrusion 20 is coupled to the leg portion of the distal C-shaped connecting arm, thereby connecting the connecting element 18. pivots about the connection portion defined by its opposing web 22, thereby disengaging the leg portion of the proximal C-shaped connecting arm and the annular groove 19 (see FIGS. 48 to 50).

In use, the clamp device 3 is transported to the target site through an endoscope, and the clamp device 3 is fixed at a predetermined position on the target site with respect to the blood vessel. In order to clamp the blood vessel, the clamp arms 7a, 7b can be repeatedly opened and closed by causing the control line 4 to move in the distal direction and the proximal direction through the actuator 5.

Once the clamp device (3) is installed, the clamp arms (7a, 7b) and the control line (4) are separated. For this purpose, the control line 4 is pulled in the proximal direction to completely close the clamp arms 7a, 7b and secure them in the closed position, as shown in FIGS. 17 to 19. These accompanying drawings show that the guide groove 11 has a straight distal end 11a extending in the axial direction, and the guide pin 12 is movable at the distal end but is separate from the clamp arms 7a and 7b. does not cause rotation of When the guide pin 12 reaches the distal end position of the guide groove 11, the guide pin is fixed/locked at this position through the retaining convex portions 21 of the clamp arms 7a and 7b. The retaining convex portion 21 extends into the straight end 11a of the guide groove 11 on the side of the guide groove, and the retaining convex portion allows the guide pin 12 to pass through the retaining convex portion to the proximal end of the guide groove 12. It is designed to reach and prevent the guide pin 12 from passing along the opposite direction. Specifically, when the guide pin 12 is pressed against the proximal side of the guide groove, the holding convex portion 21 is elastically deformed and enters the concave portion 11b on the side of the guide groove 11, The guide pin 12 passes through the retaining convex portion 21 to reach the distal end position of the guide groove 11, and when the guide pin 12 has already reached its final position, the retaining convex portion has its elastic recovery force. It is restored to its initial shape and engages the back of the guide pin 12, but when the guide pin 12 is pressed against the distal side of the guide groove, the retaining convex portion is not deformed to open the guide groove 11, and the guide pin 12 The pin 12 is designed to be locked at the distal end position of the guide groove 11. As a result, the clamp arms 7a and 7b are firmly locked to the clamp base 6 and thus are firmly locked to the clamp housing (see Fig. 42).

If the control line (4) is further pulled back, the clamp arms (7a, 7b) can no longer proceed with the displacement movement, and in this situation, the pivot pin (8) is pulled through the outlet passage (14) at the rear of the clamp arm. Pull it out from the through hole (9). In the above process, the tail ends (15, 16) located on opposite sides of the outlet passage (14) elastically open to open the outlet passage, but once the pivot pin (8) is already away from the outlet passage (14), the tail end portions (15, 16) are elastically opened. Wealth is immediately restored to its original state. To separate/release the clamp base (6) from the sheath device (2), the control line (4) is further pulled back in the proximal direction so that the protrusion (20) of the coupling head (10) is connected to the connection element (18). The legs of the inwardly distal C-shaped connecting arms are coupled to each other (see Figure 48) and the legs of these C-shaped connecting arms are pushed in the proximal direction, so that the connecting elements 18 are defined as opposing webs 22. By pivoting around the connected portion, the engagement between the leg portion of the proximal C-type connecting arm and the annular groove 19 is released (FIGS. 48 to 56).

In the process of closing the clamp arms (7a, 7b), the tail ends of the clamp arms (7a, 7b) pass through the central opening of the annular shoulder portion (17) and enter the clamp base (6). As can be seen in FIGS. 36 to 38, the lateral expansion of the clamp arms (7a, 7b) exceeds the diameter of the opening, and the clamp arms (7a, 7b) are elastically compressed upon entering the clamp base (6). , After expanding again, it is coupled to the back of the shoulder portion 17 of the clamp base 6, and locks the clamp arms 7a and 7b to the clamp base 6.

As shown in Figures 46 and 47, the process of closing the clamp arm and fixing it in the closed state can be performed simultaneously with the process of separating the control line 4 and the clamp arms 7a and 7b.

54 to 73 show another embodiment of a medical device according to the present disclosure.

The medical device according to the above embodiment includes a handle (1), a sheath device (2) attached to the handle (1), and a clamp device (3) installed at the distal end of the sheath device (2). The control line (4) extends through the sheath device (2), the proximal end of which is connected to an actuator (5), which is slidably held on the handle (1), and the control line (4) extends in a circular motion. It can be operated to move reversibly in the superior and proximal directions.

The clamp device 3 includes a clamp base 6 formed as a sleeve and two clamp arms 7a, 7b, each of which is coupled to the distal end of the control line 4. Specifically, the two clamp arms (7a, 7b) are independent elements/members coupled to the control line (4) through the pivot pin (8), and the pivot pin is installed at the distal end of the control line (4). , extends and passes through corresponding through holes 9 provided at the proximal ends of the clamp arms 7a, 7b. In this embodiment, the pivot pin (8) is installed in the coupling head (10), which is installed at the distal end of the control line (4). In the above embodiment, the coupling head 10 is flat and disposed between the clamp arms 7a and 7b, and the pivot pin 8 extends from opposite sides of the coupling head 10 to clamp the clamp arm 7a. , 7b) is provided with two pivot pin parts (8a, 8b) coupled to each through hole (9).

The two clamp arms (7a, 7b) are coupled to the distal end of the control line (4), allowing the clamp arms to rotate around a common pivot axis formed by the pivot pin (8) to realize opening and closing of the clamp arms. .

Each clamp arm (7a, 7b) is provided with a guide groove (11), and the guide grooves (11) of the clamp arms (7a, 7b) partially overlap each other. The clamp device 3 further includes a guide pin 12, which is attached to the clamp base 6 and extends to penetrate the overlapping portion of the guide groove 11, and the guide pin 12 and the guide Through the combination of the grooves 11, the movement of the control line 4 in the proximal direction is converted into a closing movement of the clamp arms 7a and 7b, and the movement of the control line 4 in the distal direction is converted into a closing movement of the clamp arms 7a and 7b. This is converted into an opening movement of the clamp arms (7a, 7b) centered on the axis.

At the proximal ends of the clamp arms 7a, 7b, a through hole 9 for the pivot pin 8 opens on the rear (proximal) side. In other words, an outlet passage 14 is provided at the tail end of the clamp arms 7a and 7b on the proximal side of the through hole 9, and after the clamp arms 7a and 7b are closed, the pivot pin 8 passes through the outlet passage. ) is pulled out from the through hole (9), and the tail ends (15, 16) of the clamp arms (7a, 7b) on both opposing sides of the opening are spread, but are not broken. As a result, the control line 4 and the clamp arms 7a and 7b are separated from the clamp device 3. Here, the outlet passage 14 consists of a slot at the tail end of the clamp arms 7a and 7b.

In the above embodiment, the tail ends 15, 16 of the clamp arms 7a, 7b are plastically deformed when opened and formed into hooks, and the hooks are coupled to the back of the shoulder portion 17 of the clamp base 6. This locks the clamp arms (7a, 7b) to the clamp base, as will be described. The shoulder portion 17 is made of an inward annular protrusion, which is installed at the distal end of the clamp base 6 and forms its distal end surface.

The sheath device 2 includes a spiral sheath 2a and a connector 2b connected to the handle 1, and the connector is installed at the distal end of the spiral sheath 2a and is laser welded to the sheath to form the sheath. This allows the device 2 to be formed as an inseparable unit. The sheath device 2 is connected to the clamp base 6 through two connection elements 18 in the form of elastic connecting arms, the two connection elements are formed on opposite sides of the clamp base, and the connection pipe 2b and forms an integrated structure. Specifically, the proximal end of the connecting element 18 is fixedly connected to the connecting tube 2b, and the free distal end of the connecting element 18 forms a coupling portion, which is attached to the outside of the clamp base 6. It engages the circumferential groove 19 provided on the surface and couples the clamp base 6 to the sheath device 2.

As can be seen from the drawing, the proximal end of the clamp base 6 extends into the connector 2b.

The connection element 18 has elasticity and is installed in the form of an elastically deformable connection arm or connection line, the proximal end of which is attached to the connection pipe 2b, and the distal end of which is an opening in the circumferential wall of the connection pipe ( 23) and extends to the outside of the connection pipe (2b), forming a coupling portion that is coupled to the annular groove (19) provided on the outer peripheral surface of the clamp base (6). Specifically, the proximal end of the connecting element 18 is fixed to the inner surface of the connecting pipe 2b, i.e. inserted into a corresponding radial hole of the connecting pipe 2b. The connecting element 18 has an inwardly protruding portion 18a located within the connecting tube 2b, and on the distal side of the protruding portion 18a the connecting element 18 is provided on the circumferential wall of the connecting tube 2b. It passes through the window 23 and extends to the outside of the connector 2b (see Figure 70).

Install a release device to separate the clamp base (6) and the connector (2b). The release device includes a protrusion 20 provided on the control line 4. The protrusion 20 cooperates with the inward protruding portion 18a of the connecting element 18 and is located between the inward protruding portions, so as to extrude the inward protruding portion 18a outward and cause the connecting element 18 to be elastically deformed. , so that its free end is pressed inward into the annular groove 19 of the clamp base 6. When the protruding portion 20 is released from engagement with the connecting element 18 by pulling the control line 4 proximally, the protruding portion 18a is deformed inward again through its elastic recovery force to recover its original shape, and the protruding portion 18a is connected. The portion is released from engagement with the annular groove (19).

To obtain the above function, set as follows. When engaging with the protrusion 20, the connecting element 18 is pushed outward and its distal portion is pressed against the inclined contact surface 240 on the proximal side of the window 23, so that the distal end of the connecting element 18 It is deformed inward so that the connecting portion is pressed into the annular groove (19). When the coupling between the protrusion 20 and the connecting element 18 is released, the latter is restored to its original shape. As a result, the contact between the distal end of the connecting element 18 and the corresponding contact surface 24 is released, thereby deforming and moving away from the annular groove 19 .

In use, the clamp device 3 is transported to the target site through an endoscope, and the clamp device 3 is fixed at a predetermined position on the target site with respect to the blood vessel. To clamp the blood vessel, the clamp arms 7a, 7b can be repeatedly opened and closed by causing the control line 4 to move in the distal and proximal directions through the actuator 5.

Once the clamp device (3) is installed, the clamp arms (7a, 7b) and the control line (4) are separated. For this purpose, the control line 4 is pulled in the proximal direction to completely close the clamp arms 7a, 7b and secure them in the closed position, as shown in Figures 17 to 19. These accompanying drawings show that the guide groove 11 has a straight distal end 11a extending in the axial direction, and the guide pin 12 is movable at the distal end but is separate from the clamp arms 7a and 7b. does not cause rotation of When the guide pin 12 reaches the distal end position of the guide groove 11, the guide pin is fixed/locked at this position through the retaining convex portions 21 of the clamp arms 7a and 7b. The retaining convex portion 21 extends into the straight end 11a of the guide groove 11 on the side of the guide groove, and the retaining convex portion allows the guide pin 12 to pass through the retaining convex portion to the proximal end of the guide groove 12. It is designed to reach and prevent the guide pin 12 from passing along the opposite direction. Specifically, when the guide pin 12 is pressed against the proximal side of the guide groove, the holding convex portion 21 is elastically deformed and enters the concave portion 11b on the side of the guide groove 11, The guide pin (12) passes through the retaining convex portion (21) to reach the distal end position of the guide groove (11), and when the guide pin (12) has already reached its final position, the retaining convex portion provides its elastic recovery force. It is restored to its initial shape and engages the rear surface of the guide pin 12, but when the guide pin 12 is pressed against the distal side of the guide groove, the retaining convex portion is not deformed to open the guide groove 11, and the guide pin 12 is not deformed to open the guide groove 11. (12) is designed to be locked at the distal end position of the guide groove (11). As a result, the clamp arms 7a and 7b are firmly locked to the clamp base 6 and thus are firmly locked to the clamp housing.

If the control line (4) is further pulled back, the clamp arms (7a, 7b) can no longer proceed with further displacement movement, and in this situation, the pivot pin (8) is connected through the outlet passage (14) at the rear of the clamp arm. Pull it out from the through hole (9). In the above process, the tail ends 15 and 16 located on opposite sides of the outlet passage 14 are plastically opened to open the outlet passage 14.

In order to separate/release the clamp base (6) from the sheath device (2), the control line (4) is further pulled back in the proximal direction, thereby connecting the projection (20) of the coupling head (10) and the connecting element (18). The inwardly protruding portion 18a is disengaged so that the connecting element 18 is restored to its initial shape when its free end is disengaged from the annular groove 19 of the clamp base 6.

In the process of closing the clamp arms (7a, 7b), the lower ends of the clamp arms (7a, 7b) pass through the central opening of the annular shoulder portion (17) and enter the clamp base (6), so that the clamp arms are connected to the clamp base (6) ) is coupled to the back of the shoulder portion 17, and locks the clamp arms (7a, 7b) to the clamp base (6).

Optionally, as shown in FIGS. 11 to 17, at least two tooth members may be provided on each of the clamp arms 7a and 7b of the clamp device 3 in the medical device provided in each embodiment of the present application. , Hereinafter referred to as side teeth, and optionally, each side tooth is formed integrally with the corresponding clamp arm (7a, 7b). Here, each side tooth has a tooth top portion and a tooth bottom portion, and the number of side teeth provided by each clamp arm is the same. Optionally, each side tooth of the clamp arm 7a on one side is symmetrical to the position of each side tooth of the clamp arm 7b on the other side, but the tooth shape is opposite. For example, as shown in FIGS. 11 to 20 of the present application, at least two side teeth on each clamp arm are arranged in symmetrical positions on both sides with respect to the axis (i.e., longitudinal center line) of the clamp arm, and the opposite Taking the clamp arm 7a on one side as an example, the shape of the left tooth of the clamp arm relative to the axis is a male tooth, and the shape of the right tooth is a female tooth, as shown in the drawing. Therefore, by rotating the clamp arm (7a) on one side by 180 degrees about its axis, the clamp arm (7b) on the other side can be obtained. Through this design, both clamp arms can be manufactured using one mold for the clamp arms 7a and 7b of the clamp device 3 provided in this application, simplifying the manufacturing process and reducing production costs. . By providing the above-mentioned side teeth on each clamp arm, the medical device can more firmly capture biological tissue, making operation more stable and controllable when applied to clinical hemostasis and wound closure.

The present disclosure provides a medical device for tissue hemostasis or suturing that is easy to operate, manufacture, and assemble. In the medical device according to the present application, since the clamp arm is directly coupled to the control line, there is no need to provide a separate connection element in the form of a J-shaped hook, for example, so the manufacturing and assembly of the medical device according to the present application can be performed. To make it easier, the lower end of the clamp arm is elastically deformed or plastically deformed when opened. This arrangement prevents the tail end from being fractured under any circumstances, thereby preventing parts of the arm that are easily fractured from remaining arbitrarily in the patient's body, and the clamp arm is directly locked to the clamp base, eliminating the need for a separate, independent locking element. It makes it easier to manufacture and assemble medical devices, and the simple structure of the clamp base maintains relatively low manufacturing costs.

1: handle
2: cis device
2a: sis
2b: connector
3: Clamp device
4: control line
5: Actuator
6: Clamp base
7a, 7b: Clamp arm
8: Pivot pin
9: Through hole
10: Coupling head
11: Guide home
11a: Straight distal end
11b: recess
12: Guide pin
13a, 13b: bearing arm
14: Exit passageway
15, 16: tail end
17: Shoulder part
18: connection element
18a: protruding part
19: Home
20: protrusion
21: Retaining convex portion
22: web
23: Windows
24: contact surface

Claims (17)

In a medical device for tissue hemostasis or suturing used through an endoscope,
handle (1);
a sheath device (2) attached to the handle (1);
A clamp device (3) comprising a clamp base (6) and at least two clamp arms (7a, 7b), wherein the clamp base (6) has a sleeve shape and is installed at the distal end of the sheath device (2);
a control line (4) extending through the sheath device (2) and moving reversibly in the distal and proximal directions; and
an actuator (5) coupled to the proximal end of the control line (4) and operated to reversibly move the control line (4) in the distal and proximal directions,
The clamp arms (7a, 7b) are each coupled to the distal end of the control line (4), and the clamp device (3) is operated through movement of the control line (4) to clamp the clamp arms (7a, 7b). ) opens and closes, the movement of the control line 4 in the proximal direction is converted into a closing movement of the clamp arms 7a, 7b, and the movement of the control line 4 in the distal direction is converted to a closing movement of the clamp arms 7a, 7b. Convert to an opening movement of the clamp arms (7a, 7b),
The clamp arms (7a, 7b) are coupled to the control line (4) through a pivot pin (8), and the pivot pin (8) is installed at the distal end of the control line (4) and extends to form the clamp. It passes through each through hole (9) provided at the proximal ends of the arms (7a, 7b), and the pivot pin (8) acts as a pivot axis when the clamp arms (7a, 7b) are closed and opened, An outlet passage 14 communicating with the through hole 9 is installed at the proximal end of the clamp arms 7a, 7b, and the outlet passage 14 is a slot at the proximal end of the clamp arms 7a, 7b. The outlet passage 14 is formed between the tail ends 15 and 16 of the proximal ends of the clamp arms 7a and 7b, and the control is performed after the clamp arms 7a and 7b are closed. The line (4) is moved proximally through the outlet passage (14) to release the pivot pin (8) from engagement with the through hole (9) and the clamp arms (7a, 7b), thereby disengaging the outlet passage ( Characterized in that the control line (4) and the clamp arms (7a, 7b) are separated by spreading but not breaking the tail ends (15, 16) of the clamp arms (7a, 7b) forming 14). medical devices. delete According to paragraph 1,
A medical device, characterized in that the lower ends (15, 16) of the clamp arms (7a, 7b) are elastically deformed or plastically deformed when opened. delete According to paragraph 3,
The tail ends (15, 16) of the clamp arms (7a, 7b) on opposite sides of the outlet passage (14) are coupled to the rear surface of at least one shoulder portion (17) of the clamp base (6), A medical device characterized in that the clamp arms (7a, 7b) are locked to the clamp base (6). According to clause 5,
The tail ends (15, 16) of the clamp arms (7a, 7b) on opposite sides of the outlet passage (14) are coupled to the rear surface of the at least one shoulder portion (17) of the clamp base (6), After the clamp arms (7a, 7b) are closed, a hook locks the clamp arms (7a, 7b) to the clamp base (6) during the process of pulling the pivot pin (8) through the outlet passage (14). A medical device characterized in that it is formed. According to clause 5,
A medical device, characterized in that the shoulder portion (17) is made of an annular protrusion of the clamp base (6). In clause 7,
The annular protrusion forms a distal cross-section having a central opening in the clamp base 6, and when the clamp arms 7a, 7b are completely closed, the tail ends of the clamp arms 7a, 7b open the central opening. passing through and extending into the clamp base (6)
A medical device characterized in that. According to any one of claims 1, 3, and 5 to 8,
A medical device, characterized in that a coupling head (10) is provided at the distal end of the control line (4), and the pivot pin (8) is installed on the coupling head (10). According to clause 9,
The pivot pin 8 has two pivot pin portions, and the two pivot pin portions are located on opposite sides of the coupling head 10 on opposite sides of the coupling head 10. A medical device, characterized in that it extends into the through hole (9) of the clamp arm. According to clause 9,
The coupling head 10 includes a U-shaped retaining structure open on its distal side, the clamp arms 7a, 7b are partially disposed between the legs of the U-shaped retaining structure, and the pivot pin 8 ) is held between the legs of the U-shaped holding structure and extends to penetrate the through hole 9 of the clamp arms 7a, 7b, and the clamp arms 7a, 7b are located between the legs of the U-shaped holding structure. A medical device characterized by extending laterally outward from the open side. According to any one of claims 1, 3, and 5 to 8,
Each of the clamp arms (7a, 7b) is provided with at least two side teeth, and at least two side teeth of the clamp arms (7a, 7b) on one side are located on both sides of the axis of the clamp arms (7a, 7b). A medical device disposed in a symmetrical position and having opposing tooth shapes. According to any one of claims 1, 3, and 5 to 8,
The clamp device includes two clamp arms (7a, 7b) and a guide pin (12),
The two clamp arms (7a, 7b) are installed as independent elements and are coupled to the distal end of the control line (4) to pivot about a common pivot axis defined by the pivot pin (8), each All of the clamp arms (7a, 7b) are provided with guide grooves (11), and the guide grooves (11) of the two clamp arms (7a, 7b) partially overlap each other,
The guide pin 12 is attached to the clamp base 6 and extends to penetrate the overlapping portion of the guide groove 11, and the guide pin 12 and the guide groove 11 are combined to form the guide pin 12. The movement of the control line 4 in the proximal direction is converted into a closing movement of the clamp arms 7a, 7b, and the movement of the control line 4 in the distal direction is centered on the pivot axis. A medical device characterized in that it is converted into an opening movement of the clamp arms (7a, 7b). According to clause 13,
The guide pin 12 is maintained between two bearing arms 13a, 13b extending in the distal direction from the clamp base 6, and is maintained at the free ends of the bearing arms 13a, 13b. Characterized medical device. According to clause 13,
A retaining convex portion 21 is provided on the clamp arms 7a and 7b, and the retaining convex portion 21 extends from a side of the guide groove 11 into the guide groove 11, and the retaining convex portion (21) is designed so that the guide pin 12 passes through the retaining convex portion 21 to reach the distal end of the guide groove 11 and prevents the guide pin 12 from passing in the opposite direction. A medical device characterized by being According to clause 15,
On the distal side of the holding convex portion 21, a concave portion 11b is provided on the side of the guide groove 11, and the holding convex portion 21 is elastically deformed to enter the concave portion 11b. , A medical device, characterized in that the guide pin (12) passes through the retaining convex portion (21) and reaches the distal end position of the guide groove (11). According to clause 15,
The guide groove 11 includes a straight distal end 11a extending in the axial direction, and the guide pin 12 moves in the straight distal end 11a, but rotates the clamp arms 7a and 7b. , and the retaining convex portion (21) extends into the straight distal end (11a).